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Experiences and Perceptions of Nursing Staff Working With Long-Stay Patients in a High Secure Psychiatric Hospital Setting

Dutta, Snigdha BSc, MSc; Majid, Shazmin BSc, MSc; Völlm, Birgit MD, PhD, DiplForPsych, MRCPsych

doi: 10.1097/JFN.0000000000000119
Original Articles

Background and Objective Forensic psychiatric nursing is a demanding nursing specialty that deals with a highly complex group of patients who are detained in restrictive environments, often for lengthy periods. There is little information about the daily experiences of these nurses. This study sought to explore the roles and relationships of forensic psychiatric nurses with long-stay patients in a high secure hospital in England.

Method and Analysis The study obtained data via three focus groups, and thematic analysis was carried out using NVIVO 10 software.

Results Five prominent themes emerged: First, nurses elaborated on their roles with patients and the kinds of interactions they had with them. The next two themes explored the reasons why some patients are long-stay patients and the challenges nurses face while working with this group. The fourth theme was the impact of external support, such as the patient’s families, on length of stay. The final theme covered the changes that the nurses observed in these patients and in themselves over time.

Conclusion It was noticeable that those interviewed were committed professionals, eager to provide an optimistic and hopeful environment for the patients to help them progress through “the system”. The study presents a number of pertinent issues regarding long-stay patients that provide a basis for further research and to inform policy, educational reforms, and clinical practice.

Author Affiliations: University of Nottingham, United Kingdom.

Source of Funding: This project was funded by the National Institute for Health Research (NIHR), Health Services and Delivery Research Programme (HS&DR, Project number 11/1024/06). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, National Health Service, or Department of Health.

The authors declare no conflict of interest.

Correspondence: Birgit Völlm, MD, PhD, DiplForPsych, MRCPsych, Section of Forensic Mental Health, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Jubilee Campus, Triumph Rd., Nottingham NG7 2TU, United Kingdom. E-mail:

Received February 9, 2016; accepted for publication June 20, 2016.

© 2016 by the International Association of Forensic Nurses. All rights reserved.
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